Abstract
Combined hepatocellular and cholangiocellular carcinoma is rare, and its incidence is reported to be 0.54 percent of primary liver cancer. The prognosis of patients with this tumor is poor, similar to that of cholangiocarcinoma. Of 423 primary liver cancers we resected from 1979 to 2004, 4 cases (0.95%) were diagnosed as combined hepatocellular and cholangiocellular carcinoma. The mean age of the patients was 67.5 years, and there were 3 men and one woman, and three of the tumors were over 5 centimeters in size. Two cases had neither HBs antigen nor HCV antibody, one had HCV antibody, and one had HBs antigen. The two cases were suspected of combined carcinoma based on both the images and tumor markers. The other two cases were preoperatively diagnosed as hepatocellular carcinoma. All the four patients showed poor prognosis (three cases died, one in 5 months, others in 3 years and 8 months, and 1 year and 10 months, and one was alive 5 months after the operation). The organs that showed recurrence were lymph nodes, liver, bones, lungs, and heart. The transarterial embolization and transhe patic artery chemotherapy were slightly effective to the recurrent disease.
